Drug monitoring in child and adolescent psychiatry for improved efficacy and safety of psychopharmacotherapy

被引：35
作者：
Mehler-Wex C. [1 ]
Kölch M. [1 ]
Kirchheiner J. [2 ]
Antony G. [3 ]
Fegert J.M. [1 ]
Gerlach M. [4 ]
机构：
[1] Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, 89075 Ulm
[2] Institute of Pharmacology of Natural Products and Clinical Pharmacology, University of Ulm, D-89081 Ulm
[3] IT-Centre, Competence Network on Parkinson's Disease, University of Marburg, D-35039 Marburg
[4] TDM Laboratory, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, 97080 Wuerzburg
来源：
Child and Adolescent Psychiatry and Mental Health | / 3卷 / 1期
关键词：
Therapeutic Drug Monitoring; Psychotropic Drug; Adolescent Psychiatry; Generation Antipsychotic; Pharmacogenetic Test;
D O I：
10.1186/1753-2000-3-14
中图分类号：
学科分类号：
摘要：
Most psychotropic drugs used in the treatment of children and adolescents are applied "off label" with a direct risk of under- or overdosing and a delayed risk of long-term side effects. The selection of doses in paediatric psychiatric patients requires a consideration of pharmacokinetic parameters and the development of central nervous system, and warrants specific studies in children and adolescents. Because these are lacking for most of the psychotropic drugs applied in the Child and Adolescent and Psychiatry, therapeutic drug monitoring (TDM) is a valid tool to optimise pharmacotherapy and to enable to adjust the dosage of drugs according to the characteristics of the individual patient. Multi-centre TDM studies enable the identification of age- and development-dependent therapeutic ranges of blood concentrations and facilitate a highly qualified standardized documentation in the child and adolescent health care system. In addition, they will provide data for future research on psychopharmacological treatment in children and adolescents, as a baseline for example for clinically relevant interactions with various co-medications. Therefore, a German-Austrian-Swiss "Competence Network on Therapeutic Drug Monitoring in Child and Adolescent Psychiatry" was founded 1 introducing a comprehensive internet data base for the collection of demographic, safety and efficacy data as well as blood concentrations of psychotropic drugs in children and adolescents. © 2009 Mehler-Wex et al; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 43 条
  • [1] Competence Network on TDM in Child and Adolescent Psychiatry
  • [2] Zito J.M., Tobi H., V.D. Berg L.T.W., Fegert J.M., Safer D.J., Janhsen K., Hansen D.G., Gardner J.F., Glaeske G., Antidepressant prevalence for youths: A multi-national comparison, Pharmacoepidemiology and Drug Safety, 15, 11, pp. 793-798, (2006)
  • [3] Fegert J.M., Kolch M., Zito J.M., Glaseke G., Jahnsen, Antidepressant Use in children and Adolescents in Germany, Jorunal of Child and Adolescent Psychopharmacology, 16, 2, pp. 197-206, (2006)
  • [4] Zito J.M., Safer D.J., V.D. Berg L.T., Janhsen K., Fegert J.M., Gardner J.F., Glaeske G., Valluri S.C., A three-country comparison of psychotropic medication prevalence in youth, Child and Adolescent Psychiatry and Mental Health, 2, (2008)
  • [5] Conroy S., Choonara I., Impicciatore P., Mohn A., Arnell H., Rane A., Knoeppel C., Seyberth H., Pandolfini C., Raffaelli M.P., Et al., Survey of unlicensed and off label drug use in paediatric wards in European countries, Britisch Medical Journal, 320, 7227, pp. 79-82, (2000)
  • [6] Knoppel C., Klinger O., Soergel M., Seyberth H., Leonhardt A., Anwendung von Medikamenten außerhalb der Zulassung oder ohne Zulassung bei Kindern, Monatschr Kinderheilkd, 148, pp. 904-908, (2000)
  • [7] Bucheler R., Schwab M., Morike K., Kalchthaler B., Mohr H., Schroder H., Schwoerer P., Gleiter C., Off-label prescribing to outpatient children, British Medical Journal, 324, pp. 1311-1312, (2002)
  • [8] Zito J.M., Derivan A.T., Kratochvil C.J., Safer D.J., Fegert J.M., Greenhill L., Off-label psychopharmacologic prescribing for children: History supports close clinical monitoring. (2008a), Child and Adolescent Psychiatry and Mental Health, 2, (2008)
  • [9] Kolch M., Schnoor K., Fegert J.M., Ethical issues in psychopharmacology of children and adolescents, Current Opinion Psychiatry, 21, 6, pp. 598-605, (2008)
  • [10] Entorf H., Fegert J.M., Kolch M., Children in Need of Medical Innovation, (2004)
12345